The John D. Thompson Hospice Institute For Education, Training and Research, Inc.

The Hospice Institute for Education, Training and Research, Inc., a not-for-profit 501(c)(3) corporation, gave its first conference in 1979 to serve as an American center for hospice education, training and research. The nationally accredited Hospice Institute is the vehicle for sharing the hospice philosophy, experience and skills with physicians, nurses, social workers, pastors, pharmacists, arts and volunteer directors, administrators, the lay community and all those who desire to improve the quality of care given in their own settings to patients and families experiencing a progressive and irreversible illness.

The Hospice Institute for Education, Training and Research, Inc. is the education and research ally of The Connecticut Hospice, Inc. In this role, it maintains the mission of educating medical professionals and the general public about the hospice philosophy and palliative care. It is the only organization of its kind that provides training programs to health care professionals and students, the lay community, and all those who desire to improve the quality of care as well as the quality of life for patients and families experiencing an irreversible illness. The Institute has been accredited to give Continuing Medical Education Category I Credits through its accrediting body, the Accreditation Council for Continuing Medical Education; Continuing Education Units approved by the Connecticut Nurses' Association or The Connecticut League For Nursing; and, Continuing Education Credits approved by the National Association of Social Workers/Connecticut Chapter.

Through The Hospice Institute for Education, Training and Research, Inc., all programs including the ACCME program serve to extend the principles of palliative care into the mainstream of medical practice and education, regionally, nationally and internationally. In doing so, patients experiencing an advanced irreversible disease and their families can be assured of receiving compassionate and competent medical care.

While too numerous to mention here, the courses with audio-visual and handbooks have been known to receive very high marks on their evaluations.

The Institute was founded in 1979. Its original goals were to change attitudes toward the terminally ill and their families, to increase the levels of skill and awareness of caregivers, to increase the body of knowledge through research, and to carry on public information programs about the type of care needed by the terminally ill. Most recent research has shown that making hospice care an option when preparing living wills, helps modify attitudes about hospice and how a terminally ill patient wishes to be cared for.

Current Institute projects are; Physician Assisted Living initiative about end of life choices; Hospice and Palliative Care Educational Outreach Training Program for medical professionals and Clerkship/Internship rotations for students. The Institute also develops and provides educational materials for use in support of group training, items include videotapes, audiocassettes, brochures and books; and serves as a speaker's bureau for community groups.

The Institute sponsors educational training, technical assistance and consultations, statewide, nationally and internationally. The following programs and activities outline the work of The Institute during 1999-2000.

Programs and Activities of The Institute:

This program is a one-day (7.0-hour) educational program for hospital-based clinicians on the philosophy and practice of palliative care and Hospice. The program is presented by The Connecticut Hospice staff, including nursing, social work, pastoral/bereavement, arts, medicine and administration. The cost of the instructors' time is allocated form Hospice to the program in the Institute. The program has been a large success and has drawn over 340 hospital-based and lay clinicians throughout the state during the past two years.

The Institute conducts clinical training for accredited programs of Clinical Pastoral Education for Pastoral student interns. Pastoral student interns come from through out the county.

Clinical Pastoral Education (CPE) is a theological and professional educational program for ministry. Now, international in scope, the CPE movement began in Worcester, Massachusetts during the nineteen twenties. Through a CPE experience, seminary students qualified lay persons, and ordained clergy learn the art of ministering to those who have spiritual needs and caring for the whole person. Units of CPE are required by some seminaries, ordaining bodies and professional chaplain organizations.

The Institute provides education to physicians that is approved by the Accreditation Council for Continuing Medical Education for Category I Credits. The program includes credits offered through Hospice and Palliative Care Educational Outreach Training Program as well as other programs developed specifically in response to requests from medical staffs or other hospitals. There is generally no revenue associated with this program.

The Institute provides technical assistance to other care providers, regionally, nationally, and internationally. The assistance includes tours of Connecticut Hospice, consulting projects, or general educational programs requested by such organizations. Charges are made for technical assistance based on an hourly fee schedule. Expenses related to the technical assistance include the allocation of Institute and Connecticut Hospice staff time, as well as any out-of-pocket expenses that may be incurred.

The Physician Assisted Living (PAL) initiative developed by the Institute and embraced by Connecticut's Attorney General Richard Blumenthal, was further developed during 1999. It was also presented to the Hospice Association of America (HAA). The program offers consumers the opportunity to embrace non-binding principles of end-of-life care. There is no revenue associated with this activity.

Following the attention focused on assisted living suicide; the Physician Assisted Living Initiative was established to offer other choices, without condemning any particular individual's decision. The PAL program offers a means for people to become more aware of their options and to indicate their desires and preferences about the care they choose to receive should the need arise. Those involved in the PAL Program discuss all of the available options with their physicians, family, clergy, and others in advance of the most severe state of their illness, which allows the opportunity to choose hospice care before experiencing the confusion and anxiety that can accompany a terminal illness.

Connecticut's Attorney General Richard Blumenthal publicly presented the first official "Notice of Desire for Hospice Care" and assists with a public education campaign to inform the citizens of Connecticut about the hospice alternative. The "Notice of Desire for Hospice Care" is clearly drafted and explains the basic tenets of hospice. It does not carry the legal weight of the living will, and clearly states that the decision for hospice care may be overridden by the physician and the patient's relatives should circumstances change and hospice care is no longer deemed the most appropriate choice. The PAL initiative establishes a patient's bill of rights, under which individuals many complete this advance directive to indicate their desire for a dignified death and palliative care. The Connecticut State Medical Society has supported the development of efforts from concept to initial publication, and devoted its entire December 1997 edition to the program.

Ten Principles of Hospice Care for Physician Assisted Living:

Patient and family are regarded as the unit of care.
Services are physician-directed and nurse-coordinated.
Emphasis is on control of symptoms (physical, sociological, spiritual, psychological).
Care is provided by an interdisciplinary team.
Trained volunteers are an integral part of the team.
Services are available on a 24-hours a day, seven-days a week on call basis with emphasis on availability of medical and nursing skills.
Family members receive bereavement follow-ups.
Home care and inpatient care are coordinated.
Patients accepted on the basis of health needs, not on ability to pay.
There are structured systems for staff support and communication.

The Institute used the services of outside professional's from time-to-time to provide consultative, legal and accounting/auditing advice. The costs of these services are directly charged to the Institute or allocated from Connecticut Hospice expenditures

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